| NPI | 1467611491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA MD-37566) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 37566) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2014-07-01 |